How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $239.88 | Professional | None | $102.33 | $162.18 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $309.03 | Professional | None | $138.04 | $199.53 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $158.49 Typical High $295.12 | Facility | None | $50.12 | $158.49 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $288.40 | Professional | None | $109.65 | $169.82 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,513.56 | $1,737.80 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $323.59 | Professional | None | $128.82 | $194.98 | $323.59 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $51.29 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $20.42 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $117.49 Typical High $165.96 | Professional | 54 · Surgery only | $75.86 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $15.14 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.23 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $109.65 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $70.79 | $109.65 | $154.88 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Tennessee· 17th of 51
$229
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.